单侧双通道脊柱内镜技术治疗腰椎管狭窄症疗效及并发症分析

doi:10.3969/j.issn.1009-976X.2025.04.005

摘要/Abstract

摘要： 目的评估单侧双通道脊柱内镜技术（UBE）治疗腰椎管狭窄症的临床疗效、安全性及并发症情况。方法回顾性分析2022年12月至2023年12月间,80例接受UBE技术治疗的腰椎管狭窄症患者的临床资料。收集并分析手术时间、术中出血量等围手术期数据。采用视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）在术前及术后3个月评估临床改善情况,并统计并发症发生率。结果所有手术均顺利完成。平均手术时间为3.35±1.18 h,平均术中出血量为49.44±53.27 mL。术后3个月,患者的VAS评分（从7.28±0.98降至1.68±0.94）和ODI评分（从0.63±0.10降至0.16±0.07）均较术前有显著改善（均P<0.001）。术后总并发症发生率为8.75%,包括切口愈合困难（3.75%）、脑脊液漏（2.5%）、硬膜外血肿（1.25%）和复发（1.25%）,所有并发症均经处理后缓解,未发现严重不良后果。结论 UBE作为一种微创手术,在治疗腰椎管狭窄症方面疗效确切,能显著缓解疼痛、改善功能,且并发症发生率低、可控。

关键词: 腰椎管狭窄, 单侧双通道脊柱内镜技术, 并发症

Abstract: Objective To evaluate the clinical efficacy, safety, and complications of unilateral biportal endoscopy （UBE） in the treatment of lumbar spinal stenosis. Methods A retrospective analysis was conducted on 80 patients with lumbar spinal stenosis who underwent UBE surgery from December 2022 to December 2023. Perioperative data, including operative time and intraoperative blood loss, were collected and analyzed. Clinical outcomes were assessed using the Visual Analogue Scale （VAS） and Oswestry Disability Index （ODI） at baseline and 3 months postoperatively. Postoperative complications were also documented. Results All procedures were successfully completed. The mean operative time was 3.35±1.18 hours, and the mean intraoperative blood loss was 49.44±53.27 mL. At 3 months post-surgery, both VAS scores （from 7.28±0.98 to 1.68±0.94） and ODI scores （from 0.63±0.10 to 0.16±0.07） showed significant improvement compared to preoperative levels （all P<0.001）. The overall complication rate was 8.75%, which included delayed wound healing （3.75%）, cerebrospinal fluid leakage （2.5%）, epidural hematoma （1.25%）, and recurrence （1.25%）. All complications were resolved with appropriate management and no severe adverse events occurred. Conclusion UBE is a minimally invasive technique that demonstrates definite efficacy in treating lumbar spinal stenosis. It significantly alleviates pain and improves function with a low and manageable complication rate.

Key words: lumbar spinal stenosis, unilateral dual channel endoscopic technique, complications

中图分类号:

R681.5

黄志谋, 缪海雄. 单侧双通道脊柱内镜技术治疗腰椎管狭窄症疗效及并发症分析[J]. 岭南现代临床外科, 2025, 25(04): 239-245.

HUANG Zhi-mou, MIAO Hai-xiong. Analysis of efficacy and complications of unilateral biportal endoscopy in the treatment of lumbar spinal stenosis[J]. Lingnan Modern Clinics In Surgery, 2025, 25(04): 239-245.

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